Complete the following and mail, fax or email to:
Brian M. Wiegmann, Department of Entomology, P.O. Box 7613, North Carolina State University, Raleigh, NC 27695-7613 Fax (919) 515-7746
Email: bwiegman@unity.ncsu.edu
Download a text version of this page here REGISTRATION FORM
Register early ! Prepayment reserves accommodation at the meeting site. On site registration will be available.
Registration form - 1 per person
Name:
Affiliation:
Address:
Estimated arrival and departure dates and times:
Check all that apply - All participants and guests must register for the meeting
______ Registration for the NADS meeting and Biting Fly workshop ($20)
______ Accommodation and meals at Camp Broadstone ($103)
______ Meals only at Camp Broadstone ($ 50)
______ I am planning to participate in the Diptera Collecting Field Day in the Great Smoky Mountains National Park 27-28 May 1999.
Total registration Summary:
_______ Option 1 $ 123 = meeting, accommodations, meals
_______ Option 2 $70 = meeting and meals only
Pre- registration and payment should be mailed to:
NADS Field Meeting, c/o Brian M. Wiegmann, Department of Entomology, Box 7613, North Carolina State University, Raleigh, NC 27695 FAX (919)515-7746;
Email: bwiegman@unity.ncsu.edu
Pre-payment by personal check or money order only
Make checks payable to: NC Ag Foundation